The 1440 Way of Email Management

By The 1440 Doctor: Jennifer Kanapicki Comer, MD

Have you ever returned from travel or a conference only to dread returning to work, not because of the clinical work, but because on the impending doom of opening your inbox? I recently faced exactly that scenario. After a recent national conference, I got back into town and sat down to tackle my inbox.  Of course I’d scanned through many of those emails while away (lost some minutes there) but now I actually had to do something about them.

The email “time suck vortex” is an issue for all of us.   A study from the McKinsey Global Institute showed that the average knowledge worker spends 2.6 hours of their day reading and answering email.  That translates to 28% of your work week dealing with emails instead of being productive!

Email is reactive and not proactive.  

When we hear or see a notification that we have a new email, we are reacting to a message someone sent to us.  It’s not proactive. It’s not submitting a grant, preparing a lecture, or writing a journal article. It’s not getting us ahead. Most importantly it’s NOT on our time.  It’s someone else dictating how we spend our minutes. This post is the first of a 2 part series on gaining control of our email. Here are the 5 steps to HAC’ing your inbox:

  • 1. Like the ED, your inbox is open 24/7.

The Harvard Business Review published an article called The Cost of Continuously Checking Email which showed that it takes 20 minutes to get back to focusing on the task at hand after even a minor distraction.  The 1440 doctor does not want to lose precious minutes! Turn off all the dings, notifications, badges that go along with a new email.  One of my colleagues was recently griping that he was having to respond to an email he received at 9:30 at night. Although he was probably looking for sympathy, my first response was “why are you checking email at 9:30pm at night?”  Email should NOT be used as an emergent form of communication needing a response within a couple of hour time frame, that’s what a phone/text is for.  Please close to ambulance traffic during non-business hours.

Turn off all email notifications.

  • 2. Schedule email checking into your day.  

The average person checks their email 15-20 times a day, or every 37 minutes.  The table below taken from the 4-hour work week depicts what that does to your productivity (shown in light gray).  As shown, it really breaks up your day not allowing for many productive time blocks.  

The 4-hour work week recommends checking your email twice a day, once at noon and again at 4pm.  These are times you are likely to have the most responses from emails you have already sent.  The author, Tim Ferris, even states you should set up an autoresponder that lets others know you only check your email twice a day and if something is urgent than you could be contacted by phone (not sure if this would fly in my department).

Also, be strategic the time of day you check email.  People are most productive in the morning. Don’t use your most productive, highest cognitive capacity hours being reactive to email.

  • 3. Unsubscribe.  

I can’t tell you how many times I open my email inbox to find spam.  I often think, “Did I really subscribe to all these newsletters? How did I not “uncheck” that box when I signed up?”  Each one of these unwanted emails takes minutes of your life to scan, sift through and delete. They are cluttering your inbox, stealing minutes and taking your attention away from the important emails. Unsubscribe!  Every unwanted email I scroll to the bottom and unsubscribe myself. Now they can’t steal more minutes the next time they email me. A fast way to do this (and discover scamers you didn’t even know about) is to use  It will not only show you all the subscription emails that come to your inbox (I had 79!) but let’s you easily unsubscribe to them.  You can even create a daily “roll up” which will be emails you do want in one easy digestible email.

  • 4. Dispo each email.  

Think of every email as a patient you need to dispo.  You definitely don’t want to sign out that patient that’s been here most of your shift.  Dispo them! Let’s apply the 4D’s we covered before to our in baskets. It’s your scheduled time to tackle email, you’ve cleared out all the unwanted subscriptions, now dispo each email using the 4D’s:

Do it.  Do you need to complete your hospital’s harassment online training?  Is there a required wellness survey you need to fill out? Some things just need to get done.  Touch it once! Especially if it will take 2 minutes or less. It will only take more cognitive effort to come back to these tasks and rethink about them.

Delete it. There has been this email in my inbox for about a week.  It’s asking for help with a medical student lab. It’s still in there because I do want to help but my schedule is full and from reading a ton of time management books “Every yes, is a no to something else.”  Delete the email “no’s.” Delete all the clutter emails, or better yet quickly scroll down the email and hit “unsubscribe” to not allow it to bother you again.

Delegate it.  Probably one of my favorite D’s.  Is this an email that necessitates your expertise or could it be handled by an admin?  Email advertising upcoming SAEM, forward it to your admin with a simple sentence asking them to register you.  Upcoming guest lecturer needing visit information, hit forward with a sentence to let admin know to send them details.  Look at each email and think if it needs your input/time or can it be handled by someone else.

Defer it.  If you don’t have one already, set up a folder system.  I like to organize my folders for my responsibilities. My work section has a folders for interview season, the medical education fellowship, mentees, just to name a few.  So when I get an email about the mentees I’ve been assigned I simply file it in the mentee folder. If you are deferring something that still requires your attention I would flag it (and make sure you have a system of handling your flagged emails).

  • 5. Want to get to inbox 0?  

If your like me your email inbox won out for some time in your battle with it.  I got close to 4 digits in my in basket when I knew I needed to change my relationship with my emails.  So if you need a fresh start do the following.

  1. Select all the emails in your inbox
  2. Click to “achieve” them
  3. You’re at inbox 0!

I gave a talk on this to my faculty and many laughed at this point calling it “cheating.”  While yes, this is a backdoor way to get to inbox 0, that 6 year old email isn’t going to get rid of itself.  If your worried about your email platforms “archive” function, create a folder and move all your current in basket into it.  

Stop letting email think your the ED, open 24 hours a day.  Schedule tackling your emails and dispo them first pass. If you need a restart don’t be afraid to get to inbox 0 in a less conventional way.  I won’t judge!

1440 Doctor Action items:

☑️ Think about when it’s the best time in your day to check your email.  Schedule this into your day like you schedule a meeting. Try to have this be only 2-3 times per day.  Set a hard deadline in the day when you stop checking email.

☑️ Go to and be amazed by all the unwanted emails distracting you from the important ones.  Unsubscribe, or place in a daily “roll up” emails that clutter your in basket.

Want more?